“The Darkest Corners”: Abuses of Involuntary Psychiatric Commitment in China A report by CHRD to the UN Committee on the Rights of Persons with Disabilities for its review of the People’s Republic of China in September 2012 August 6, 2012 Introduction.....................................................................................................................................2 I. Involuntary Patients in Psychiatric Hospitals Are Deprived of Their Liberty Unlawfully and Are Detained Because of Their Disabilities............................................................................................5 II. Patients in Psychiatric Hospitals Are Assigned “Guardians” Without Legal Procedures...........10 III. No Effective Access to Justice for Persons Held Against Their Will in Psychiatric Hospitals....13 IV. Cruel Treatment, Violence, and Abuse Common in Psychiatric Hospitals...............................18 V. Patients in Psychiatric Hospitals Are Restricted or Prevented from Communicating with the Outside World................................................................................................................................21 IV. Conclusion and Recommendations..........................................................................................21 Appendix I: Individuals Detained in Psychiatric Institutions between 2008 and 2012 Following Their Petitioning and Human Rights Activism...............................................................................24 1 Introduction It was 2 a.m. one day in April 2011 when Xu Wu ( 徐武 ) pried open a window, squeezed out of the narrow opening, and escaped from Wuhan Iron and Steel Workers No.2 Hospital’s Mental Health Ward. Four years earlier, Xu’s employer and Wuhan police had taken him to the hospital against his will, and he had been held there until his daring escape. Xu said that he was not mentally ill but was hospitalized in retaliation for making complaints about his employer to government authorities. However, he was diagnosed as suffering from “paranoia,” and the hospital said he had shown no improvement over the years. After his escape, Xu found his way onto a television program in Guangdong, where he told his compelling story. Just as he was leaving the TV station, a group of men (one of them claiming to be a police officer) seized Xu, pushed him into a car, and drove off. Xu was then taken back to the same hospital, but his story set off a firestorm of debate in China. In online forums, people disputed whether he was really mentally ill and, if so, whether the hospital, his employer and the police broke the law in keeping Xu virtually locked up in the hospital. 1 China’s involuntary commitment system is a black hole into which citizens can be “disappeared” for an indefinite period of time based on the existence or mere allegation of a psychosocial disability by family members, employers, police or other state authorities. According to one official estimate, 800,000 people are admitted to psychiatric hospitals in China every year. 2 Many of them, like Xu, are brought to hospitals against their will, often by force. The hospitals then admit these individuals and do not allow them to leave unless those who have had them committed agree that they can be discharged. The involuntary commitment of persons who have or are alleged to have psychosocial disabilities is a violation of the Convention on the Rights of Persons with Disabilities (CRPD). 3 In the psychiatric hospitals, patients are denied the right to make decisions and are at the mercy of the hospitals and those who took them there. The latter are assumed by the hospitals to be “guardians” of these individuals. These patients are often subjected to forced treatment, including medication and electric shocks. Chinese laws and regulations currently do not provide such individuals with the right to an independent review of their mental health status or the legality of their detention; nor is there a right to a court hearing or access to counsel. Patients are often denied communication with the outside world. Causes behind the abuses of the involuntary psychiatric commitment system 1 CHRD, “Xu Wu, Who Had Flown Over the Cuckoo’s Nest, Arrives in Beijing Seeking Everyone’s Help ( 武汉飞越疯人院者徐武 到北京向各界求救 ),” January 28, 2012, http://wqw2010.blogspot.hk/2012/01/blog-post_28.html . Xu was eventually released due to the widespread attention to his case. 2 Wu Fengqing, “Suggestions for Mental Health Law Focusing on Protection of Patients ( 建言精神卫生法 直指患者保障 ),” China Hospital CEO Magazine, February 2, 2012, http :// www . h - ceo . com / html /2012/02/2012020218130900049179. shtml . 3 Convention on the Rights of Persons with Disabilities was adopted on 13 December 2006 by the United Nations. The full text is available at http://www.un.org/disabilities/convention/conventionfull.shtml . 2 A combination of factors—namely, a deficient legal and regulatory framework, coupled with a lack of judicial independence—is primarily to blame for this state of affairs. There is no law in China specifically dedicated to protecting the rights of those with psychosocial disabilities. While there are several national laws that touch on certain aspects of involuntary commitment —for example, the Criminal Law (CL) and the Police Law (PL)—they are vague and do not specify the circumstances or the procedures under which an individual can be involuntarily committed. Some local legislatures in China have drafted their own regulations regarding involuntary commitment. These regulations authorize involuntary commitment in a wide range of situations. Currently, neither national laws nor local regulations provide judicial oversight during the commitment process. In cases where patients have sued hospitals or the individuals who committed them, courts have generally not shown a willingness to address the issues and provide effective remedies for those unlawfully committed. Although the Chinese government released a draft Mental Health Law (“draft MHL”) for public comment in October 2011, the law has not yet been enacted by the National People’s Congress (NPC), and it is unclear when it will be subject to a vote. 4 Moreover, the draft appears to codify the current involuntary commitment system, which violates the CRPD. The use of involuntary psychiatric commitment for political purposes The current system of psychiatric confinement is also highly vulnerable to abuse. Those who have the means—power and money—to either compel or pay psychiatric hospitals to detain individuals out of a desire to punish and silence them have been able to do so with impunity. In 2002, Human Rights Watch published a seminal report on the use of involuntary commitment for political purposes, primarily against political dissidents and Falun Gong practitioners. 5 Ten years on, politically-motivated abuses within the psychiatric commitment system remain. Currently, many of those involuntarily committed by state agents are petitioners 6, along with dissidents and activists. In Appendix I, we have included a sample of 40 cases of individuals 4 The law has been in the works since 1985 and has seen 16 drafts. Those who have observed the drafting of the law attribute the difficulties to the complexities of the issue, including taking into account the opinion of various powerful interest groups such as the Ministry of Public Security. There are Chinese news reports which say that the draft will be passed in 2012, but this has yet to be seen. For example, see Jiang Bo, “National People’s Congress To Revise Labor Contract Law, Intends to Pass Mental Health Law this Year ( 人大今年将修订劳动合同法 拟通过精神卫生法 ),” Caijing , March 12, 2012, http://politics.caijing.com.cn/2012-03-12/111737358.html . 5 Human Rights Watch, “Dangerous Minds: Political Psychiatry in China Today and its Origins in the Mao Era,” August 12, 2002, http://www.hrw.org/fr/reports/2002/08/13/dangerous-minds . See also Robin Munro, “Judicial Psychiatry in China and its Political Abuse,” The Journal of Asian Law , Volume 14, Number 1, Fall 2000. 6 China has an official petitioning system which permits citizens to bring grievances against the local government to the attention of authorities at higher levels. Officially, the Chinese government encourages petitions and has an extensive governmental bureaucracy to handle them. In practice, however, officials at all levels of government have a vested interest in preventing petitioners from speaking up about the mistreatment and injustices they have suffered. The Chinese government has developed a complex extra-legal system to intercept, confine, and punish petitioners in order to control and silence them, often employing brutal means such as assault, surveillance, harassment of family members, kidnapping, and incarceration in secret detention centers, psychiatric institutions and re-education through labor facilities. For more information about the treatment of petitioners, see CHRD’s report, “Silencing Complaints: Human Rights Abuses Against Petitioners in China,” January 8, 2008, http://www.chrdnet.com/2008/03/14/silencing-complaints-human-rights-abuses-against-petitioners-in-china/ . 3 detained in psychiatric institutions between 2008 7 and 2012 following their petitioning and human rights activism. In most of these cases, activists were taken to psychiatric hospitals to punish them after they acted in ways that irked government officials, such as petitioning higher authorities or publishing articles criticizing the government. These are only some examples of cases documented